A Report of a Case Involving Body Lateropulsion with Numbness of the Ipsilesional Fingers Caused by a Small Infarction in the Dorsal Part of the Middle Medulla.

Based on the complexity of functional anatomy, a small infarction in the medulla can produce various types of clinical symptoms or signs depending on the location of this infarction. We describe the case of a 46-year-old man who presented with sudden onset of body lateropulsion to the left side and numbness of the ipsilateral fingers. 3-tesla diffusion-weighted magnetic resonance imaging with a section thickness of 2 mm revealed a small infarction in the dorsal part of the left middle medulla. To our knowledge, this is the first case report describing vestibular dysfunction apparent upon otoelectrophysiological examination but without vestibular symptoms or signs except for body lateropulsion.

Changes in Blood Flow Velocity of the Middle Cerebral Artery After Carotid Endarterectomy: Daily Assessment with Transcranial Color-Coded Sonography.

BACKGROUND: Hyperperfusion syndrome (HPS) is a well-known complication of carotid endarterectomy (CEA) warranting repeatable inexpensive monitoring. Transcranial color-coded sonography (TCCS) may provide a potential modality for such monitoring, but little is known about TCCS trends after CEA. METHODS: Between January 2016 and February 2017, we prospectively included patients with CEA at our institute in this study. TCCS was performed preoperatively and repeated daily from the operation day until postoperative day (POD) 7. Daily trends in mean flow velocity (MFV) at the M1 portion of the middle cerebral artery were compared between patients with and without HPS. RESULTS: Among 35 patients with CEA, daily TCCS monitoring was performed in 18 patients (mean age ± SD, 72 ± 7 years; male/female, 17:1). Among these 18 patients, 3 had probable HPS. On POD 0, MFV of the 18 patients showed a 32% increase from the initial preoperative value (from 52.5 to 69.4 cm/s, P = 0.0013). This increased MFV lasted for several days and recovered gradually by POD 7. Patients with probable HPS demonstrated a trend to higher MFV than those without; however, the difference was below the significance level. CONCLUSIONS: We used daily TCCS after CEA to depict cerebral blood flow changes after CEA in our cohort. This technique may be useful both for the detection and prevention of HPS.

Reversible hippocampal lesions detected on magnetic resonance imaging in two cases of transient selective amnesia for simple machine operation.

We report two extremely rare cases involving the development of transient selective retrograde amnesia for simple machine operation lasting for several hours. A 61-year-old male taxi driver suddenly became unable to operate a taximeter, and a 66-year-old female janitor suddenly became unable to use a fax machine. They could precisely recount their episodes to others both during and after the attacks, and their memories during their attacks corresponded to the memory of the witness and the medical records of the doctor, respectively. Therefore, it appears that these individuals remained alert and did not develop anterograde amnesia during their attacks. On day 4, they underwent high-resolution magnetic resonance imaging (MRI), and diffusion-weighted MRI with 2-mm section thickness revealed small high-intensity signal lesions in the left hippocampal cornu ammonis area 1 (CA1) region. However, these lesions disappeared during the chronic phase. This is the first report describing lesions detected by MRI in patients with transient selective amnesia without anterograde amnesia. Reversible damage to the hippocampal CA1 region may cause transient selective amnesia by impairing the retrieval of relevant memories.

Ipsilateral sensorimotor deficits in lateral medullary infarction: a case report.

The patient, a 32-year-old man, presented with sudden onset of occipital headache, vertigo, dysarthria, gait ataxia, right Horner syndrome, numbness of the right hand, and mild right hemiparesis. On magnetic resonance imaging, an acute small infarction was located on the right side of the caudal medulla extending dorsomedially. Magnetic resonance angiography showed severe right vertebral artery stenosis. Lateral medullary infarction associated with ipsilateral sensorimotor deficits in the limb is very rare, and the lesion probably involved the ipsilateral dorsal column or decussating lemniscal fibers and corticospinal fibers caudal to the pyramidal decussation or compression of the decussation.

[Survey of current conditions regarding awareness of the nutritional role of supplements for pharmacy students].

Various nutritional supplements have become available in recent years. However, health problems resulting from the misuse of these supplements are on the rise, and have been attributed to a lack of knowledge among consumers. In addition, a survey of university students revealed that approximately 20% of students erroneously considered nutritionally balanced supplements as substitutes for meals. Given this background, we conducted a questionnaire survey of first- and fourth-year students at the Faculty of Pharmaceutical Sciences at Kobe Gakuin University with the objective of elucidating factors such as the awareness of supplements among pharmacy students and whether these students had a superior understanding of supplements compared to the general student population. Awareness of supplements among students was determined in terms of the degrees of emphasis on meals and supplements in nutritional intake. The proportion of students who essentially believed that "nutritionally balanced supplements can be used as substitutes for meals" did not significantly differ between pharmacy students and the general student population. In addition, only 30% of students had an accurate understanding of supplements. Following graduation, pharmacy students may become pharmacists and thus be responsible for providing directions regarding usage of supplements. These findings suggest that in order to nurture professional pharmacists, it is necessary to first implement practical nutrition education and consumer education to promote healthier dietary habits among the students themselves.

Epoxidation with an electrocatalytic p-450 model system in an acidic solution.

An electrochemical P-450 model system using meso-tetraphenylporphyrinatomanganese(III) chloride (MnTPP), imidazole and acetic acid was tested in an acetonitrile solution, and epoxide was obtained with a good current efficiency. The results of cyclic voltammetry revealed that acid plays an important role in the second electron transfer.